All articles by Zhiburt E. B.

Management in health care

2017 № 4
The load on the blood service of medical establishments depending on the volume of platelet transfusions per days of week

Rate of the frequency of transfusions, goal-setting, and the stratification of 1519 doses of donor platelets on different days of the week have been evaluated in 16 clinics in the Republic of Bashkortostan. The proportion of transfused platelets in the different days of the week has been different at 5.1 times. The needs of clinics, from Sunday to Tuesday inclusive in platelets make up 17.2% of the total consumption and at 61,3% (p < 0,01) more often than on other days of the week are met by apheresis platelets. Maximum uniformity of platelet transfusion dates identified in Children Republic Clinical Hospital, which from Wednesday to Friday inclusive, transfuses 51.2% of platelets, whereas in other hospitals – 76,8% (p < 0,01). Increased frequency of platelet therapy beginning on Friday in small clinics can cause compliance audit for transfusion rules. The results may be useful for evaluating workflow of blood service clinics, improve the efficiency of clinical work.

Based on the cost analysis of different types of platelet concentrates (PC) assessed the effectiveness of the introduction of technology pooling of platelets in the Irkutsk Regional Blood Transfusion. Comparative cost analysis of different types of PC, the cost of consumables for the same therapeutic dose PC was performed. It was found that the content of pooled PC cells does not give in to apheresis. The introduction of technology pooling of platelets allows significantly (by 54,4% or more) to reduce the cost of issuing PC. To evaluate provision of PC in the regions it is advisable to consider the number of harvested PC through methods for preform at therapeutic doses.

Existing indicators of statistical reporting on blood transfusions in the Russian hospital are invalid and suggest keeping mixed blood and blood components and are not subject to unequivocal interpretation. Scholastic use of the existing statistical indicators makes them practically unusable, and the impossibility of any analysis of transfusion therapy in Russian clinics.

2013 № 8
Features of the national remuneration for blood donation (Pirogov National Medical Surgical Center, Moscow, Russia)

Order of the Ministry of Health of Russia from 17.12.2012 № 1069n «About approval of the cases in which the possibility of putting blood and (or) its components for a fee, and the amount of such fee» requires to create the paid blood donors group based on the extended red blood cell phenotyping and to identify evidencebased clinical use of the regulated phenotypes blood. Необходимо to provide for the expenses in the budget of the blood service and to amend the technical regulation on blood safety, the instructions for use of blood components, standards of medical care, standard for the labelling of blood and exemplary staff of the organization.

Management in healthcare

2017 № 10
Benchmarking of blood transfusion in regions of the Russian Federation

Blood transfusion statistics in Russia has been evaluated. In 2016 about 1.2 million patients of Russian clinics received more than 3.2 million transfusions of blood and its components in a total volume of about 1 million liters. About 0.5% of Russian doctors certified in the specialty «Transfusiology». The practice of transfusion of blood components in the RF subjects is very variable. The degree of heterogeneity of the clinical transfusion has been determined: the decile coefficient of some indexes in the regions of Russia in 2016 amounted to: transfusionists provision – 5.31; the number of recipients of blood on 1 transfusionist – 4.91; the part of transfusionists among doctors – 3.70; the part of recipients of blood among the population – 3.04, the volume of blood transfusion for 1 recipient 1–2.43; the volume of 1 blood transfusion – 2.29; the number of blood transfusions for 1 patient – 1.74. It seems appropriate for further statistics of clinical transfusion evaluation: the term «transfusion» replaced by the term «unit»; to evaluate the practice of transfusion of different blood components separately

Medical paperflow

By Delphi method with 58 experts there was carried out a three-step search for indicators reporting on the work of blood transfusion. Lapidary report form containing number of transfused blood components units and recipients has been proposed.

Population and healthcare

2018 № 8
Transfusion of blood: there are fewer recipients than it seems

It is known that in 2016 a total of 1,196,633 patients of Russian clinics received blood transfusion. The correctness of these data is questionable, since Table 3200 of Report Form 30 does not imply a summation of transfusion of different blood components. In 2 hospitals, the number of blood recipients receiving different transfu¬sion products was determined. It is established that about 25% of patients receive complex transfusion therapy with various kinds of blood components. Summation of data on the number of recipients of different transfusion products (Table 3200 of Form 30) leads to a distorted result, 30% higher than the actual number of patients who received a blood transfusion.

Special opinion

2016 № 6
Features of the national biological crossmatch for blood transfusion

Knowledge of 184 physicians on the procedure of the biological crossmatch at the beginning of bloodtransfusions has been studied. Special formalized questionnaire was established for answers to the 4 questions aboutnumber of drops in 1 ml of blood; about actions during the biological crossmatch; about diagnostic monitoringmethods; about records. An ambiguous understanding of the regulatory requirements has been found. The maximumfrequency of the most popular answer to the questions was 49.1%, 44.2%, 74.5% and 47.9%, respectively. It isadvisable to change the text of the standards in order to harmonization of scientifically sound international practice.